<!DOCTYPE html>
<html>
  <head>
    <meta charset="UTF-8">
    <title></title>
  </head>
  <body>
    <form action="http://www.google.com/" method="post">
      <label for="firstname">First name:</label>
        <input type="text" id="firstname"><br/>
      <label for="lastname">Last name:</label>
        <input type="text" id="lastname"><br/>
      <label for="address">Address:</label>
        <input type="text" id="address"><br/>
      <label for="city">City:</label>
        <input type="text" id="city"><br/>
      <label for="state">State:</label>
        <input type="text" id="state"><br/>
      <label for="zip">Zip:</label>
        <input type="text" id="zip"><br/>

      <label for="phone">Phone:</label>
        <input type="text" id="phone"><br/>
      Area Code: <input type="text" id="areacode1">
	Phone: <input type="text" id="phone1"><br/>
      Phone:
        <input type="text" maxlength="3" name="hphone1">
	- <input type="text" maxlength="3" name="hphone2">
	- <input type="text" maxlength="4" name="hphone3">
	ext.: <input type="text" maxlength="5" name="hphone4"><br/>
      Phone:
        ( <input type="text" maxlength="3" name="hphone1a"> )
	<input type="text" maxlength="3" name="hphone2a">
	- <input type="text" maxlength="4" name="hphone3a">
	ext.: <input type="text" maxlength="5" name="hphone4a"><br/>
      Phone:
	<input type="text" maxlength="2" name="hphone1b">
	<input type="text" maxlength="3" name="hphone1b">
	- <input type="text" maxlength="3" name="hphone2b">
	- <input type="text" maxlength="4" name="hphone3b">
	ext.: <input type="text" maxlength="5" name="hphone4b"><br/>
      Phone:
        <input type="text" maxlength="2" name="hphone1c">
	( <input type="text" maxlength="3" name="hphone1c"> )
	<input type="text" maxlength="3" name="hphone2c">
	- <input type="text" maxlength="4" name="hphone3c">
	ext.: <input type="text" maxlength="5" name="hphone4c"><br/>
    </form>
  </body>
</html>
